Provider Demographics
NPI:1437964160
Name:HARWELL, KIANNA
Entity type:Individual
Prefix:
First Name:KIANNA
Middle Name:
Last Name:HARWELL
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:ANACIEL
Other - Middle Name:
Other - Last Name:HARWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3905 RACKING HORSE RD
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-2986
Mailing Address - Country:US
Mailing Address - Phone:910-303-8215
Mailing Address - Fax:
Practice Address - Street 1:351 WAGONER DR STE 325
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4674
Practice Address - Country:US
Practice Address - Phone:910-491-0061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician